Group CBT Relieves Menopause Symptoms After Breast Cancer

Group cognitive behavioral therapy (CBT) is an effective tool in reducing menopause-related symptoms in women with a history of breast cancer, according to new research published in The Lancet Oncology.

Hormone replacement therapy is often contraindicated or undesirable in women who have had breast cancer, but as many as 85% of these women will experience hot flashes and night sweats that negatively impact their quality of life. Dr. Eleanor Mann, researcher in the MENOS Research Group in the Health Psychology Section at King’s College in London, and colleagues conducted a randomized controlled trial to determine if group cognitive behavioral therapy improved quality of life. Women were recruited from clinics and included in the study if they reported a minimum of 10 problematic episodes of hot flashes and night sweats per week after breast cancer treatment.

Participants were randomized to receive usual treatment (N=49) or usual treatment plus group cognitive behavioral therapy (N=47); women were stratified by age (i.e., under 50 years old or over 50 years of age). Women in the cognitive therapy group received one 90 minute session a week for 6 weeks; group cognitive behavioral therapy included psychoeducation and paced breathing as well as cognitive and behavioral strategies to manage their menopausal symptoms. Mann and colleagues conducted assessments at baseline and then again at 9 weeks and 26 weeks to assess adjusted mean differences in the problem rating (1 to 10) of hot flashes and night sweats between treatment groups.

Mann et al. found that women who received group cognitive behavioral therapy fared better than their counterparts who only received usual care. In comparison to women in the usual treatment group, women who received cognitive behavioral therapy realized a mean difference of -1.67 in problem rating after 9 weeks after treatment initiation. Moreover, a reduction in problem rating was maintained throughout the follow-up, with a mean difference -1.76 at 26 weeks. Mann and colleagues did not find any adverse events associated cognitive behavioral therapy.

“Group CBT [cognitive behavioral therapy] seems to be a safe and effective treatment for women who have problematic HFNS [hot flashes and night sweats] after breast cancer treatment with additional benefits to mood, sleep, and quality of life,” the authors concluded. “The treatment could be incorporated into breast cancer survivorship programmes and delivered by trained breast cancer nurses.”

“Cognitive behavioral therapies are brief, effective, non-medical treatment options for menopausal women that can be delivered by trained health professionals,” Dr. Myra Hunter, co-author of the study and professor of clinical health psychology and consultant clinical psychologist at King’s College, explained in a statement to the press. “Our finding that self-help therapies can be as effective as group therapies is very exciting as we are keen to increase access to these kind of psychological therapies.”

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References:

References:
Mann E, Smith, MJ, Hellier J, et al. Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial. Lancet Oncology. 2012; Feb 15 [Epub]. Kearney C. Cognitive behavioral therapy - effective in treating menopause symptoms. Medical News Today. Feb 15, 2012.